Sweet Dreams and Armpits

A is for…

I'll start off with the second part of the title first.
When I get a trauma case, my priorities are ABC, or C-ABC

C-spine (some experts put this first, so we don't forget to immobilize the cervical spine)

Airway: is the patient talking? Bleeding? Suffering from a burn that will close off the airway?

Breathing: now check the lungs and chest. Look at the respiratory rate and oxygenation.

Circulation: is s/he bleeding anywhere? How are the blood pressure and heart rate?

D is for disability, which means a neurological exam. Pupils, reflexes, and strength if the patient will cooperate.

Dr. Scott Weingart, an emergency physician intensivist based in New York, emphasizes E for Exposure in penetrating trauma. You need to find the entry and exit points so the patient doesn’t bleed out from a bullet wound in the back while you’re messing around with a chest tube in the front.

So even before establishing airway, if the patient is maintaining an airway and has no blunt injuries, Dr. Weingart inspects “every square centimetre” of the patient’s skin, including the axillae, the back, the gluteal folds and the perineum, including lifting up the scrotum in a male patient. A much catchier mnemonic, proposed by Dr. Robert Orman, an emergency physician in Portland, Oregon, is: “armpits, back, butt cheeks and sack.”

With thanks to Leigh Lundin for pointing out that I had forgotten to post, and to the Medical Post for originally printing this clinical pearl.

Sweet Dreams

And now for a happy dance: one of my writing dreams has come true. When I looked at Rob Lopresti's column, I recognized the Forensics book cover by Val McDermid.

Why? Because it was chosen as one of CBC's best crime books of the season--along with my own Stockholm Syndrome.

Kris Rusch has said that you should make sure you set writing goals, which are within your control, as well as dreams, which are pies in the sky.

Well, I've been wanting to get on CBC's The Next Chapter for years. So I updated my list of writing dreams and goals here.

Goal: unlocked!

Of course, I have approximately 2 million other unrealized goals, but it's a start. How about you? What are your writing goals and dreams?

Signing out so I can get some sleep before my ER shift tomorrow. I hope I won't need to use my C-ABCDE mnemonic, but you never know what'll happen.

Peace.

Nothin' But The Best

As part of my tireless effort to make the world a better place I am once again listing all the best short mysteries of the year, thereby saving all the other award judges from a lot of tedious reading.  (Well, they could add these to their assigned list. I wouldn't mind.)

I recommend that all those judges take the time they save and do something good for society.  I would help, but I have to start reading next year's stories.

This is the seventh time I have made an annual list.  By coincidence, there were 14 stories on last year's list, and the same number this time.

The big winner this year was Ellery Queen's Mystery Magazine, with four stories.  Tied with two each are Sherlock Holmes Mystery Magazine, Strand Magazine, Thuglit, and the Jewish Noir anthology.

Nine stories are by men; five by women.  (That's one more female winner than last year.)  Four are historical, four are funny, two are parody/pastiches.

Okay.  Drum roll, please...

Camilleri, Andrea.  "Neck and Neck,"  in The Strand Magazine," October 2015-January 2016.

Montalbano,  Camilleri's series character, is appointed Chief Inspector in a village in Sicily, and discovers that a Mafia family feud is well under well.  A member of the Cuffaros is snuffed out with an old-fashioned shotgun, and then one of the Sinagras dies the same way.

But then something highly irregular happens.  Two members of the same family are killed in a row.  How unseemly!  And Montalbano spots a way into the maze of silence...

Faherty, Terence.  "The Man With The Twisted Lip," in Ellery Queen's Mystery Magazine, February 2015.

My former co-blogger Terence Faherty is making his third appearance on my annual best of list.  Only three other  authors have scored that many times.

Faherty claims to have discovered Dr. John Watson's notebooks, containing the rough drafts of Sherlock Holmes adventures, before they were "cleaned up for publication."  This is the fourth in his series.

Both versions begin with a woman calling at the home of Watson and his wife, desperate because her husband has disappeared.  In Doyle's version the man is a drug addict and has vanished into an opium den.  In Faherty's tale the same man is a serial philanderer and is apparently staying in a hotel of bad repute. 

"My husband returns!" Rita exclaimed.
"Not a moment too soon," Holmes said.
"You don't understand.  He's insanely jealous.  And violent.  If he finds me in here--"
Holmes sprang up.  "Watson, I bow to your experience.  Under the bed?"

Gould, Heywood.  "Everything is Bashert," in Jewish Noir, edited by Kenneth Wishnia, PM Press, 2015.
I have a story in this book.  Heywood Gould's tale is about Franny and Larson, two petty lowlifes who like to spend their days at Aquaduct. And it is at that race track one day that they run into a hasidic gentleman they call the rabbi (he isn't).  The rabbi has a Bible-based system for betting on the horses, a sure thing of course, and yet somehow he is short of money.  Go figure.  Our heroes lend him some cash and, well, a wild ride commences that involves among other things, breaking into a morgue, and ends with a sort of spiritual enlightment.  A treat from start to finish.

Hockey, Matthew J.  "Canary,"  in Thuglit, 18, 2015.

Booster is a fireman with a chemistry degree, which earns him the dubious privilege of being the first into a meth lab gone deadly.  He's the one who enters in full HAZMAT gear and has to determine if all the idiots inside were killed by the poisonous brew they created or whether there might be survivors. And this time he finds  a bag stuffed with four hundred grand.  Obviously he ought to leave it where it lies, but who will know if he doesn't?  And so he takes one step off the straight-and-narrow...


Kareska, Lane.  "Big Hard Squall,"  in Thuglit, issue 17, 2015.

Abby has been brutally attacked and locked in the trunk of her car, which is now headed for parts unknown.  We stay in Abby's head as she runs through her life and concludes that there is no one who would want to do this to her.  Therefore the target must be her daughter Margaret, a prosecuting attorney.  Either someone wants to punish Margaret or else put a squeeze on her, and Abby is the pawn in jeopardy.  But when the trunk lid opens Abby and us - are in for surprises.

Lewis, Evan.  "The Continental Opposite,"  in Alfred Hitchcock's Mystery Magazine, May 2015.

What chutzpah.  Lewis has revived Dashiell Hammett's Continental Op.

This story takes place in the fifties, decades after the Op's last appearance.  The main character is a young detective named Peter Collins (he notes bitterly that his father deliberately gave him a name that is gangland slang for "nobody").  Peter works for the Portland, Oregon branch of a national detective agency and when he accuses his boss of corruption the company sends in a retired op who used to work for the San Francisco branch ("sometime in the forties Continental had put him out to pasture, and he'd spent the years since killing a vegetable garden, sneering at golf courses, and not catching fish.").  This guy strongly resembles Hammett's hero, much older and, if possible, more cynical. A brilliant story.

Liss, David.  "Jewish Easter,"  in Jewish Noir, edited by Kenneth Wishnia, PM Press, 2015.

Al's family moved from Long Island to Jacksonville, Florida, when he was in third grade, because of his stepfather's import business.  Now he is thirteen and has begun to figure out exactly what is being imported.

But that's not his immediate problem.  There are a couple of anti-Semetic rednecks in his class and when they hear about Passover (which the sensitive teacher helpfully describes as "Jewish Easter,") they decide to invite themselves forcefully to the seder.  Let all who are hungry come and eat, right?

What I loved about the story is not the suspense but the surprising choices the characters make (especially the grandmother).  It kept me guessing right up to the last paragraph.

Maron, Margaret.  "We On The Train!"  in Ellery Queen's Mystery Magazine, May 2015.  

Greg McInnis is a DEA agent who prefers to travel by train.  On a trip up the east coast he is amused by a young African-American woman who is gleefully phoning everyone she knows to tell them that she is going to visit New York with an older man she says is her Uncle Leon.

Sounds innocent enough, but this is a crime story, so something else must be going on here.  Will our hero figure it out in time?  He only has four pages...

Newman, Kim.  "Red Jacks Wild,"  in Sherlock Holmes Mystery Magazine, Issue 17, 2015.

John Carmody is a psychologist in New York in 1951.  He also happens to be Jack the Ripper.

Wait a minute, you say.  He'd have to be a hundred years old.

Well, he is.  But he looks the same age he did in the 1880s when he started making human sacrifices to the evil goddess Hecate.  Which he still does, every three years.

But not prostitutes every time.  He alters his "disposables,"  choosing victims from a  group no one will care about.  Which makes him a weathervane pointing at whoever is on the bottom of the social pile.  This story is all about America's twisted psyche, and I loved it.

Opperman, Meg.  "The Discovery,"  in Sherlock Holmes Mystery Magazine, Issue 18, 2015.

While studying at a university in her native Venezuela Celeste meets and marries Robert  and moves to Washington, D.C.  Robert is  a classic abusive, controlling, husband.  Celeste's every move is watched, her phone calls monitored.  When her bus home is late she is beaten.

 Reaching into a hand-carved box, I sort through the gold jewelry and select Robert's latest apology.

But what makes this story more than just a tale of domestic misery is that each scene is prefaced with a quotation from Christopher Columbus's letters or logbooks, describing his encounters with the natives of the new world.  It is no accident that Celeste and Robert get married on Columbus Day.

Palumbo, Dennis.  "A Theory of Murder,"  in And All Our Yesterdays, edited by Andrew MacRae, Darkhouse Books, 2015.

The publisher sent me this book for free.

It's Bern, Switzerland, 1904.  Hector, a clerk in the patent office, is suspected of a series of grisly murders.  Luckily a friend of his, also a patent clerk, is looking into the crimes.  And Albert Einstein is a pretty bright guy...  Wish I'd thought of that.

Ross, Gary Earl.  "Good Neighbors,"  in Buffalo Noir, edited by Ed Park and Brigid Hughes, Akashic Press, 2015.

Lou and Athena have retired after running their Greek restaurant for decades.  Lou's hobby is antiques.  He doesn't collect them, he just wants to buy low and sell high.  But then he discovers that his elderly neighbor Helen has a house full of the things.  And Helen has no relatives, no favorite charities, no one to leave her precious belongings to. So Lou and Athena set out to become really good neighbors and wait for Helen to pass away.

But then the Washingtons  move in on the other side, and it turns out that they are good neighbors too. This story is well-written, beautifully structured, and  one of those rare pieces I reread as soon as I finished it.

Rozan, S.J. "Chin Yong-Yun Meets A Ghost,"  in Ellery Queen's Mystery Magazine, March-April 2015.

This is my buddy S.J. Rozan's second story told by the  formidable mother of her series detective Lydia Chin.  When Mrs. Chin  gets a phone call from Gerald Yu she is annoyed  for three reasons.  First, Yu is a gambler and not very bright.  Second, he wants to involve daughter Lydia in his troubles.  And third, he happens to be dead.

"It's about my death, but it's not vengeance I'm after.  Also, it's not really about my death, because I'm not dead."
"Who told you that?  They're lying."

Rusch, Kristine Kathryn. "Christmas Eve at the Exit,"  in Ellery Queen's Mystery Magazine, January 2015.

This is Ms. Rusch's second appearance on my annual best list.

It is Christmas eve and Rachel and her little girl are on the run.  Many pages will pass before we find out from who, and about the shadowy support system that is helping them.

Rachel is terrified, not sure who to trust, and desperately trying to keep up an appearance of normality for her daughter who, heartbreakingly, seems mostly concerned about Santa Claus. This story will appear in holiday-themed anthologies for years to come.

Animal Instinct

My last posting concerned the grey hinterland of human mind control and was extremely taxing to write, so I often found myself contemplating the family's fifteen year old corgi as a means of  mental relaxation.  She seldom appeared to have a lot on her own mind, but napped in apparent comfort as I labored away.  Occasionally, she might stir herself to stretch and shift positions, or sit up to peer out the window onto our street.  This last would only happen if something truly important roused her, such as a UPS truck going by (she hates UPS...don't ask me why, as I've always equated the truck with Christmas gifts and happy times).  She, on the other hand, has held a grudge against Big Brown since she was a pup many moons ago.  By people years she is 105 and, apparently, has a long memory when it comes to grievances, real or imagined.  She holds the vacuum cleaner (any model) in the same contempt, and just as inexplicably.



A good corgi--not Silke

In case you don't know, a Welsh corgi is an ancient breed of cattle dog.  I found this idea laughable, at first, as Silke (that's her name--she was christened by my offspring who also found her) has short little legs and I couldn't imagine her herding cows, or even sheep, for that matter.  But then, I am a low and ignorant knave.  Corgi means dwarf in Welsh (hence the short leggies) and this allowed them to nip easily at the ankles of their wards while avoiding being kicked--being so low to the ground they can drop quickly beneath the damaging arc of the cow's hoof.  The official book on these furry devils warns, "Not for first-time owners".  That's right; that's what it says.  Care to guess what we were?

It seems this invaluable breed of canine tend to be bossy and are prone to nipping.  Thanks, kids.  I guess that shouldn't surprise anyone who knew what they were bred for--being bossy to a bunch of cows and nipping their hooves.  But I had no idea what the kids were getting us into.  Corgis are highly resistant to Mind Control.  This last is my own admonition as, believe me, I have tried.  But Silke remains serenely impervious to all attempts at training or discipline.  I gave up years ago--Pavlov did not use Welsh corgis in his famous experiment .  This shouldn't have surprised me, really, as my own progeny have also resisted my every effort at mind control.  It makes perfect sense that they should somehow, while on a trip to Virginia, manage to find just this dog in a pet store.  The shop owners claimed that they had no idea what kind of mutt it was...sure they didn't.

Though resistant to all discipline imposed upon them, corgis happily impose their own special brand of rules on everyone else.  For instance, running, and other erratic movements, are greatly discouraged, as are overt signs of physical affection, unless those affectionate overtures are directed at the corgi.  Try cuddling up to your loved one and soon the thick, furry body of the Adversary inserts itself betwixt the two of you like a mobile chastity pillow.  As for games of chase when the kids were younger...this was strictly forbidden!  Silke would fly into action by rapidly circling the offending parties in ever-tightening spirals until all motion was halted.  I cannot recall how many times I have tripped over this beastie.  I suspect that this latter trait is why corgis are so favored by the Queen of England--the herding instinct insures that all in the royal party will move about in a decorous manner; assume a stately progress.  The alternative is to be either tripped or bitten.  I have read that many of her guests (and family) despise the little beggars.

Did I mention that Silke hates all other canines?  With a passion.  She admits of no other dog being an ally or kindred spirit.  She recognizes no kinship.  I don't know if this applies to her own breed, as they are somewhat rare this side of the pond, but I suspect she would be just as unforgiving with them as any other.

Well, of course, those same children who had to have this creature, grew up and went away to college and thence to their own lives.  Silke and me are still here.  She thinks Robin, my wife, is just swell, though I am the one left mostly in charge of her...did I say, "in charge"?  Well, you get the picture.  I do the walks, the feedings, and now, the insulin injections.  Mostly, anyway.  Yes, she has diabetes and has had for the past four years.  The vet gave her a year at most after diagnosing her--if  we gave her the insulin.  I came from a background that was less than sentimental about pets, being descended from farm folk who routinely slaughtered barnyard animals and hunted game.  There were no pets, as such.  Yet, Silke has prevailed even against my notoriously budget-minded ways.  We buy the hideously expensive insulin.  She yet lives.

She has also appeared in a number of my stories.  She has played the protagonist, victim, and villain with equal aplomb.  I get a kick out of working her into my efforts from time to time.  Because the truth be told, her completely uncompromising nature, besides being infuriating, also charms and intrigues me.  Animals have always had this effect on me, and probably a third, or better, of everything I've ever written involves animals and nature in various roles both great and small--by my count, fourteen out of thirty stories.

Sometimes they just provide a bit of atmospheric background, such as the clutch of neighborhood turkey vultures in "The Vengeance of Kali".  In other stories they provide warnings, or are harbingers of something terrible coming--a small dog (possibly a corgi) in "Spooky"; a lizard in "Tap-Tap", while in some they are the victims, as a cat and corgi each in "The Mole" and "Whistle".  But, in the interest of fair-handedness, animals are sometimes the victimizers as well: a cougar and spider in "Natural Causes", a zoo tiger in "Copy Cat", a corgi in "Little Things" and in "The Wisdom Of Serpents"...yep, serpents. 

I didn't start out to write about animals so frequently; it just happened.  In fact, for the first ten years of my taking up the pen, I was unaware that I was doing so.  It was only after I had built up a small body of work that I gradually became cognizant of the recurrent nature of...well, nature, in my stories.

It's not that I write animal stories, as such, it's just that they figure in so often.  I'm not alone in this, oh no; in fact, several Big Shot Writers in the mystery and suspense field have gotten there long before me--E.A. Poe and H.H. Munro of past renown, as well as Kristine Kathryn Rusch and Doug Allyn of more recent note.  I stumble along in the paths of others.  But, I wouldn't be able to exclude wee beasties, and great, even if I wanted to.  They are all around us and figure into our lives though we dwell in suburbs or great cities. 

Just this morning, I was beckoned by a sparrow to open the door to my garage and free her.  This was not an isolated incident.  For some time now, whenever the weather is rough with rain or heavy winds, a sparrow hides herself (or himself) I'll never know which, within our attached garage as we pull the car in.  Come the morning, she begins to sing...loudly.    This is our cue to open the damn garage door and release her from her voluntary confinement.  This is accomplished on a regular basis.  At first, I thought it was just a case of the sparrow having inadvertently entered the garage and become trapped when we shut the door.  But repeated experience has shown me differently.  Is it the same bird, each time?  I will never be sure, but it is always a sparrow.  Additionally, there is no nest in the garage.  And it never happens when the weather is nice.  Also, she never sings while in the garage until daylight comes and the weather has cleared.  Gives the pejorative 'bird-brained' a slightly different slant, doesn't it?  But it does make me think, and whenever I do that I start to have ideas that sometime become stories, and when I write stories I become a happier person.  So, my little sparrow may not be the bluebird of happiness, and my dog may not be Lassie, but they both do me a world of good.


Sparrow